Antenatal Corticosteroids for Late Preterm Delivery: Comparison of Neonatal Outcomes

Augusta Arruda, Mariana Ormonde, Sarah Stokreef, Beatriz Fraga, Catarina Franco, Ana Lima, Catarina Dâmaso

Abstract

Aim: Late preterm (LPT) neonates are at a high risk of acute morbidities and mortality. Evidence regarding the use of antenatal corticosteroids (ACSs) after 34 weeks of gestation is still debatable as studies show conflicting results. This study aims to compare the outcomes in LPT neonates exposed and unexposed to ACSs.

Materials and Methods: This was a retrospective cohort study. Neonatal outcomes including morbidities at birth and respiratory and general morbidities were studied. Maternal demographic and obstetric data were analyzed as possible confounders.

Results: We studied 390 infants. Almost half (n = 189; 48.5%) received ACSs for pulmonary maturation. We observed that neonates exposed to ACSs were more likely to present the following statistically significant outcomes: need for oxygen supplementation and noninvasive respiratory support, prolonged hospital stay (> 5 extra days), feeding through nasogastric tube, phototherapy to treat jaundice, and need for sepsis evaluation.

Conclusion: Overall, ACS-exposed LPT neonates presented the worst neonatal outcomes. Studies in literature that compared neonatal outcomes in LPTs exposed and unexposed to ACSs present conflicting results. The results of our study support recent guidelines advocating the nonroutine use of ACSs in LPTs. As our study was retrospective, further prospective studies are needed to substantiate these results.